Teresa Jo Bormann, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AK5061 Issued in AK

Practice address

521 E Sioux Ave
Pierre, SD 57501-3142

Phone

(605) 945-5560

Fax

(605) 224-0369

NPI assigned

Jan 24, 2006

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment Care Compare group NPD
• Avera St Marys

  • General Acute Care Hospital
  • Pierre, SD
  • NPI 1669457180

  SD

  Medicare reassignment NPD
• Avera St Marys

  • Emergency Medicine Physician
  • Pierre, SD
  • NPI 1073305496
  NPD
• Avera St Marys

  • Multi-Specialty Clinic/Center
  • Pierre, SD
  • NPI 1720326713
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  Hospital

  Care Compare affiliation

Specialty

Family Practice

Education

University of North Dakota School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Butte Indian Health Service Hospital 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eagle Butte Indian Health Service Hospital Hospital, Eagle Butte, SD, CCN 431383

Medicare fee-for-service enrollment

Enrolled in TX, SD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tbormann507665@ak.providencedirect.org

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 4, 2022.

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1487624482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E SIOUX AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013142",
            "telephone_number": "605-945-5560",
            "fax_number": "605-224-0369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 E 36th Ave",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084372",
            "country_code": "US",
            "telephone_number": "907-562-9229",
            "fax_number": "907-561-4806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORMANN",
        "first_name": "TERESA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "AK5061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbormann507665@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "1201 E 36th Ave",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbormann507665@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "3200 Providence Dr",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vicki Blake-Nafus, PA
• Anthony Ray Blake, D.C.
• Matthew Thomas Blaseg, OD
• Kirsten Bluestone
• Katherine Bonnichsen, MD
• Michelle M Bowman, CCDCI
• Melissa Jane Boyer, PSY.D.
• Catherine Margaret Brandner
• Myranda Brandner, CNP, PMHNP-BC
• Bright Well Midwifery PLLC

• All providers in Pierre, SD
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.